Provider First Line Business Practice Location Address:
92 NORTH MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST. REGIS FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12980
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-856-9421
Provider Business Practice Location Address Fax Number:
518-856-0142
Provider Enumeration Date:
01/02/2007